MR. MARK MITCHELL ROUBIDOUX II


Address: 201 18th Ave, Lewiston, ID 83501-2768
Phone: 2083053537

MR. MARK MITCHELL ROUBIDOUX II (NPI# 1629685235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629685235
Entity Type Individual
Full Name MR. MARK MITCHELL ROUBIDOUX II
Practice Address 201 18th Ave
Lewiston
ID 83501-2768
Practice Telephone 2083053537
Mailing Telephone 2083053537
Enumeration Date 2020-09-28
Last Update Date 2020-09-28
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2100X Nurse Practitioner
Specialization: Acute Care
39235 ID Physician Assistants & Advanced Practice Nursing Providers

Other Providers MARK ROUBIDOUX

NPI Name Taxonomy Address Enumeration
1285814186 Mark Roubidoux Nurse Anesthetist, Certified Registered 1221 Highland Ave, Clarkston, WA 99403-2829 2007-11-07

Office Location

Street Address 201 18TH AVE
City LEWISTON
State ID
Zip Code 83501-2768

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1679193759 Jacqueline M Aldrich Behavior Technician 3407 12th Street C, 3407 12th Street C, Lewiston, ID 83501 2020-04-20
1295228054 Provident Foundation - Wedgewood Terrace LLC Alzheimer Center (Dementia Center) 2114 Vineyard Avenue, Lewiston, ID 83501 2018-06-07
1164945325 Xiaofei Liu Massage Therapist 234 Thain Rd, Lewiston, ID 83501 2017-07-19
1467909879 Sharon Thulon Registered Nurse 1118 F Street, Lewiston, ID 83501 2016-09-01
1821459496 Gem State Endoscopy Clinic/Center 3709 14th Street, Lewiston, ID 83501 2016-03-10
1508264995 Gary L. Grogan Psychologist 633 Main Street, B#1, Lewiston, ID 83501 2014-12-17
1003189366 John Joseph Johnson Dentist 3510 12th Street, Suite #600, Lewiston, ID 83501 2012-02-17
1306134077 Rowena Kathryn Jackson Counselor 531 Bryden Avenue, Lewiston, ID 83501 2011-07-15
1912290388 Staci Leanne Truby Massage Therapist 717 'd' Street, Lewiston, ID 83501 2011-05-18
1093040685 Sharie Ann Uhlorn Registered Nurse 1837 Alder Court, Lewiston, ID 83501 2009-10-15
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Taxonomy Information

Taxonomy Code 363LA2100X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Acute Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1700359544 Marcello Romeo Nurse Practitioner 300 Main St, Lewiston, ME 04240-7027 2019-01-04
1710343777 Patricia Rand Nurse Practitioner 93 Campus Ave, Lewiston, ME 04240-6030 2016-01-06
1619241908 Scott Andrew Smith Nurse Practitioner 300 Main St, Lewiston, ME 04240-7027 2012-03-04
1194714568 Vera J Komisarjevsky Nurse Practitioner 93 Campus Ave, Lewiston, ME 04240-6030 2005-10-18

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1275199663 Jason T Elliott Nurse Practitioner 12094 N Barn Owl Way, Boise, ID 83714-1363 2019-05-12
1699055491 Nicole Dawn Bartlett Nurse Practitioner 243 Cheney Dr W Ste 200, Twin Falls, ID 83301-4278 2011-08-24
1174707442 Tracy K Matalon Nurse Practitioner 3340 E Goldstone Way, Meridian, ID 83642-1026 2007-12-21
1639364482 Saint Alphonsus Specialty Services Inc Nurse Practitioner 660 E Boise Ave, Boise, ID 83706-5118 2007-09-13
1780879536 Saint Alphonsus Specialty Services Inc Nurse Practitioner 2809 Cleveland Blvd, Caldwell, ID 83605-4443 2007-09-13
1962522409 Wendy Swope Nurse Practitioner 3388 Highway 26, Irwin, ID 83428 2007-03-29
1609808328 Nancy Nuce Taylor Nurse Practitioner 3525 E Louise Dr Ste 500, Meridian, ID 83642-6305 2006-07-06
1336193598 Angela K. Hughes Nurse Practitioner 6933 W Emerald St, Boise, ID 83704-8616 2006-05-20
1174156962 Rachel Lynne Davis Nurse Practitioner 190 E Bannock St, Boise, ID 83712-6241 2020-02-20
1205489978 Kimereng Kipchumba Kipsuge Nurse Practitioner 1717 Arlington Ave, Caldwell, ID 83605-4802 2019-07-22
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Competitor

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City LEWISTON
Zip Code 83501

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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